[건강 플러스] ④’Allergic rhinitis’, choking pain in spring

Source-Clip Art Korea

Source-Clip Art Korea

Spring is a season of love and hate for allergic rhinitis patients. As the day warms, the scenery of flowers blooming and sprouts on the trees makes even the mind refreshing, but when pollen starts to blow up and the yellow dust overlaps, you will have to suffer breathlessly from the intensifying rhinitis.

Sneezing, stuffy nose, and runny nose that continues without attempts are uncomfortable and painful, but from last year it is similar to the symptoms of Corona 19, so it is easy to be misunderstood as a suspected symptom.

Although the prevalence of infectious diseases is decreasing, the prevalence of allergic rhinitis is steadily increasing. According to the National Statistical Portal of the National Statistical Office, the prevalence of allergic rhinitis in Korea increased from 12.1% in 2008 to 16.7% in 2018, and even more serious in adolescents, from 22.8% in 2008 to 31.7% in 2018.

Corona blue, may worsen rhinitis

Allergic rhinitis is caused by environmental and genetic factors. The increase in indoor life due to urbanization and air pollution due to industrialization are considered to be the main causes of the increase in allergic diseases. Allergic rhinitis is also a genetic factor. If either parent has allergic rhinitis, the probability of developing allergic rhinitis in a child is about 50%.

Allergic rhinitis is divided into’perennial allergic rhinitis’, in which symptoms worsen and improves repeatedly throughout the year, and’seasonal allergic rhinitis,’ in which symptoms worsen in certain seasons. ‘Perennial allergic rhinitis’ is mainly caused by house dust mites, mold, dog or cat hair, dandruff, and excrement, while’seasonal allergic rhinitis’, which has severe symptoms only at certain times, is mainly caused by tree pollen.

Kim Dong-eun, a professor of otolaryngology at Keimyung University Dongsan Hospital, explained, “In the case of seasonal allergic rhinitis caused by pollen, symptoms appear immediately after exposure, and perennial allergic rhinitis caused by house dust mites is characterized by severe symptoms early in the morning.”

Symptoms appear in the order of itching, sneezing, watery runny nose, and stuffy nose, and may be accompanied by nasal sounds, mouth breathing, snoring, sleep disturbances, loss of sense of smell and taste, and chronic cough.

Professor Kim said, “The prevalence is lower in rural areas than in urban areas because of differences in urban and rural environments and lifestyles that affect the distribution of major antigens. Mental stress can also aggravate symptoms, which is caused by’Corona Blue’,” said Professor Kim. “Stress can make allergic rhinitis symptoms worse.”

Source-Clip Art Korea

Source-Clip Art Korea

◆Easily test for antigens through blood test

Allergic rhinitis is diagnosed through a questionnaire for symptoms, a family history of allergies, nasal endoscopy, and tests to find the causative antigen.

The skin test is a basic test that can identify the causative agent of allergic rhinitis. The causative antigen can be identified by injecting an antigen extract that is suspected to be the cause into the skin of the arm or back and observing the changes in the skin. However, if you are taking an antihistamine, it may affect the results, so you should stop taking the drug for a certain period of time before undergoing an examination.

Recently, a number of tests for specific antigen antibodies (Ig E test) through simple blood tests have been performed. It is a test that collects the patient’s blood and measures a specific antibody against a specific antigen. It can be tested with a single blood collection.

Allergic rhinitis is the most important first-line treatment because the causative antigen irritates the nasal mucosa and causes symptoms. To prevent house dust mites, the biggest cause of allergic rhinitis, cover pillows and bed mattresses, and wash blankets and clothes with hot water of 60 degrees or higher. It is best not to use carpets or fabric sofas indoors.

It is advisable to wear a mask on a day when there is a lot of pollen in spring, and to check the spring weather forecast and refrain from going out on the day when the pollen warning is issued.

Patients with allergic rhinitis should be cautious because they may exhibit hypersensitivity reactions to yellow dust, pollutants, cigarette smoke, and temperature changes in addition to specific antigens.

◆Antihistamines are effective in improving symptoms

It is difficult to completely prevent allergic rhinitis just by prevention. If you already have allergic rhinitis symptoms, you need to receive medication in time to improve your quality of life and prevent complications from progressing. Allergic rhinitis can progress to various complications such as chronic sinusitis, otitis exudative, sleep disorders, cognitive dysfunction, and mental disorders.

Nasal washing with saline removes mucus containing various inflammatory mediators and increases mucociliary movement. It can remove secretions from the nose and improve nasal congestion.

Oral antihistamines quickly relieve symptoms of runny nose such as sneezing, itching, and water. Topical steroids sprayed into the nose are also more effective in improving nasal congestion symptoms than other drugs. However, topical nasal mucosa shrinkage, a type of spray, immediately improves nasal congestion symptoms, but long-term use may cause serious side effects such as drug addictive rhinitis, so caution is required.

Dong-eun Kim Professor, Department of Otorhinolaryngology, Keimyung University Dongsan Hospital

Dong-eun Kim Professor, Department of Otorhinolaryngology, Keimyung University Dongsan Hospital

Immunotherapy is a treatment that reduces allergic rhinitis symptoms when exposed to antigens by weakening the hypersensitivity to antigens in advance. There are’subcutaneous injection’, in which antigen is injected subcutaneously, and’sublingual immunotherapy,’ in which the antigen must be held in the mucous membrane under the tongue. Since a treatment period of at least 3 years is required and the treatment cost is not small, it is necessary to carefully decide when there is no improvement in symptoms due to drug treatment or when drug treatment is no longer possible due to drug treatment side effects.

There are many disagreements about the effectiveness of surgery in the treatment of allergic rhinitis. Even with nose surgery, the constitution that causes allergic rhinitis does not change. However, if you suffer from chronic hypertrophic rhinitis in which the nasal mucosa is thickened due to prolonged allergic rhinitis, partial inferior turbinate resection can reduce the pain of nasal congestion.

Help Dong-eun Kim Professor, Department of Otorhinolaryngology, Keimyung University Dongsan Hospital

Source